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Socioeconomic and health-care factors explain the higher risk of diabetes and poorer health outcomes, including mortality, in people with severe mental illness compared to people with diabetes alone.

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Jennie Lister 1, Lu Han 1, Sue Bellass 2, Jo Taylor 1, Sarah L Alderson 2, Tim Doran 1, Simon Gilbody 1, Catherine Hewitt 1, Richard IG Holt 3,4, Rowena Jacobs 5, Charlotte EW Kitchen 1, Stephanie L Prady 1, John Radford 6, Jemimah R Ride 7, David Shiers 8,9,10, Han-I Wang 1, Najma Siddiqi 1,11,12,*

1 Department of Health Sciences, University of York, York, UK
2 Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
3 Faculty of Medicine, University of Southampton, Southampton, UK
4 University Hospital Southampton NHS Foundation Trust, Southampton, UK
5 Centre for Health Economics, University of York, York, UK
6 Patient and public involvement representative, Keighley, UK
7 Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
8 Division of Psychology and Mental Health, University of Manchester, Manchester, UK
9 Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
10 Primary Care and Health Sciences, Keele University, Keele, UK
11 Hull York Medical School, University of York, York, UK
12 Bradford District Care NHS Foundation Trust, Bradford, UK
* Corresponding author Email: najma.siddiqi@york.ac.uk

Declared competing interests of authors: Sarah L Alderson has received funding from the Wellcome Institutional Strategic Support Fund and National Institute for Health Research (NIHR) Clinical Trials Fellowship during the conduct of the study, and is a member of the Health Services and Delivery Research funding committee. Simon Gilbody is deputy chairperson of the NIHR Health Technology Assessment (HTA) Commissioning Board (2017 to present), and is a member of the HTA Funding Committee Policy Group (2017 to present) and the HTA Post-funding Committee teleconference (2017 to present). He was a member of the HTA Commissioning Committee (2008–17). Catherine Hewitt is a member of the NIHR HTA Commissioning Board (2015 to present). Richard IG Holt has received honoraria for speaker engagements, conference attendance or advisory boards from AstraZeneca plc (Cambridge, UK), C.H. Boehringer Sohn AG & Ko. KG (Ingelheim am Rhein, Germany), the European Association for the Study of Diabetes (Duesseldorf, Germany), Eli Lilly and Company (Indianapolis, IN, USA), Janssen Pharmaceutica (Beerse, Belgium), Menarini Group (Florence, Italy), Mylan NV (Canonsburg, PA, USA), Novo Nordisk A/S (Bagsværd, Denmark), OmniaMed Communications Ltd (London, UK) and Otsuka Pharmaceutical Co., Ltd (Tokyo, Japan), outside the submitted work. Furthermore, he was a member of the HTA Prioritisation Committee C (Mental Health, Women and Children’s Health) until July 2019. David Shiers is an expert advisor to the National Institute for Health and Care Excellence (NICE) centre for guidelines and a member of the current NICE guideline development group for rehabilitation in adults with complex psychosis and related severe mental health conditions. He is also a board member of the National Collaborating Centre for Mental Health (NCCMH) and a clinical advisor (paid consultancy basis) to the National Clinical Audit of Psychosis (NCAP); these are the personal views of David Shiers and not those of NICE, NCCMH or NCAP. David Shiers has received personal fees from the publication Promoting Recovery in Early Psychosis (French P, Smith J, Shiers D, Reed M, Rayne M. Promoting Recovery in Early Psychosis: A Practice Manual. Chichester: Wiley-Blackwell; 2010), as a joint editor in receipt of royalties, and has received personal fees as a member of the current NICE guideline development group for rehabilitation in adults with complex psychosis and related severe mental health conditions.

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